Individual provider Active NPI

Jozef S Mruk, MD

  • Cardiovascular Disease Physician
  • Wichita, KS
National Provider Identifier
1023053683
Registry record updated Jul 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
26205 Issued in KS
Practice address
3311 E Murdock St
Wichita, KS 67208-3054
Phone
(316) 689-9370
Fax
(316) 689-9363
NPI assigned
Jun 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 26205 KS Primary

Addresses

Primary practice location

3311 E Murdock St
Wichita, KS 67208-3054

Mailing address

PO Box 8035
Wichita, KS 67208-0035
Phone (316) 689-9135

Other identifiers 6

IdentifierTypeStateIssuer
202931OtherKSHPK
12149464OtherKSMULTIPLAN
17015OtherKSCOVENTRY
058674OtherKSBCBS
100185550CMedicaidKS
12961OtherKSPHS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
26205KSMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Via Christi Hospitals Wichita Inc. Past Accepting new patients
Ascension Via Christi Hospitals Wichita Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341792000000",
    "number": "1023053683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8035",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672080035",
            "telephone_number": "316-689-9135",
            "fax_number": "316-689-9102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 E MURDOCK ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672083054",
            "telephone_number": "316-689-9370",
            "fax_number": "316-689-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MRUK",
        "first_name": "JOZEF",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2012-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KS",
            "license": "26205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPK",
            "identifier": "202931",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "12149464",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "17015",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "058674",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100185550C",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHS",
            "identifier": "12961",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.